Super-Aged

Japan’s demographic shift heralds new era in healthcare innovation

By John Amari

Earlier this year, The ACCJ Journal was among media invited to the Kansai Resilience Forum 2019, an event organized by the Government of Japan in collaboration with the International Academic Forum (IAFOR), a non-profit interdisciplinary think tank based in Nagoya.

With guest speakers and panelists from government, academia, and the business sector, the forum, which was held at the Hyogo Prefectural Museum of Art in Kobe City, had a theme of “resilience as a positive and necessary trait for survival in individuals and societies.” A topic of discussion was economic revival, especially the city’s emergence as a center of biomedical research following the 1995 Great Hanshin-Awaji Earthquake.

In light of the forum’s themes, which included the role of healthcare policy in resilient societies, The ACCJ Journal had an exclusive interview with Kazumi Nishikawa, director of the Ministry of Economy, Trade and Industry (METI) Healthcare Industries Division, part of the ministry’s Commerce and Services Industry Policy Group.

Following is an excerpt of his wide-ranging comments, which touched on such topics as Japan’s “super-aged” society, open innovation in the healthcare system, and the road to preventive and lifestyle-support healthcare.

INTERVIEW WITH DIRECTOR KAZUMI NISHIKAWA

What are your current healthcare priorities?The goal is very simple: we would like to create an active society in which people have long lives. This means, towards the end of life, you would like to be socially engaged and in good health. We are keen on improving the healthcare status of every generation.

In addition, we would like to encourage social connectivity or involvement—especially for the elderly. How can technology, social systems, and industries help to realize such societies? Finding those solutions is our goal.

How are demographics changing?Japan is a super-aged society. Our aging rate—the growth of the number of people aged 65 years or more—exceeds 27 percent. That makes us first in the world. This number will reach 38 percent in 2060.

Does this change Japan’s role in global policy?The demographics will bring a change from a 19th-century model to a 21st-century one. In the 19th century, elderly people were rare. But in the 21st century, they are the main component of societies—comprising between 30 and 40 percent of the population. Japan will be the first nation in the world to enter this transition.

So, the Japanese model can be beneficial to other countries. In such a situation, our challenge is not to change this demo-graphy—we can’t go back to the 19th century—but rather to improve the healthcare status of every generation. We would like to create a society in which life-long activities are possible. In other words, how do we create “super grandpas” and “super grandmas”?

What does this mean for the average person?Dr. Hiroko Akiyama, a gerontologist at The University of Tokyo, studied elderly Japanese for 20 years. Her conclusion was simple: If you are healthy at 65, you have a high probability of maintaining a high quality of life towards 90. But, if you have bad health at 65, you are, in general, likely to end up bedridden in later years.

The answer to how to create super-grandpas and grandmas is that you should be very healthy at age 65. Therefore, during your working age, you should not sacrifice your health for work or productivity. You have to strike a balance.

Why does Japan have so many healthy seniors?About 10 percent of Japanese grandpas, for example, maintain very high independence and quality of life until they are 90. Dr. Akiyama analyzed the background of these grandpas and found that they have a high degree of connectivity with society; their social participation is very high.

In addition, elderly leaders of a community, or those who are members of a volunteer group, tend to be healthier than those without such social involvement. Social participation is the key to good health among the elderly.

How will lifestyle shape healthcare policy?Lifestyle choices are very important. In addition to the Ministry of Health, Labour and Welfare, which is responsible for activities inside hospitals, others are trying to improve the healthcare status of people living in Japan. This includes METI and ministries of: International Trade and Industry; Land, Infrastructure, Transport and Tourism; and Internal Affairs and Communications.

Can medicine and tech tackle lifestyle-related diseases?Lifestyle-related diseases cannot be cured by medicines. Of course, we have some medicines for such things as hypertension, or treatments for diabetes, but without changing your lifestyle, such diseases cannot be cured.

To elaborate, the main causes of death among Japanese people are cancer, renal failure, cerebrovascular disease, dementia, and senility. Medical doctors and hospitals tend to look at the treatment and recuperation stage of such ailments—and how to cure people who already suffer from them.

From our side, a change in lifestyle is very important. We would like to invest more—and urge people, local government, and companies to invest more—in the preventive stage of health-care. Preventive healthcare is key.

What role can businesses play?From the point of view of data, for instance, you have to combine medical data, which can be accumulated from inside hospitals, and non-medical or lifestyle-related data, which can be accumulated by lifestyle-related industries and technologies such as social media, e-commerce, wearables, the Internet of Things, and artificial intelligence.

How you combine data to provide comprehensive solutions for patients—the “total-life system”—is key to treating non-communicable diseases. The question is: How can medical applications for patients be improved using new technologies?

These questions will form part of the recently announced Future Innovations Working Group and the joint vision of METI and the Ministry of Health, Labour and Welfare which looks to 2040.

Part of the solution is that pharma-ceutical and medical companies should shake hands with other industries, including those related to IT. This kind of industrial transforma-tion is now going on. Therefore, we—the government, academia, and businesses—should invest more in prevention and life-support-type healthcare systems. This is my main message.

HEALTHCARE INNOVATIONIn his closing comments, Nishikawa spoke about health and productivity management, and how companies can make investments in employee healthcare management to improve productivity at work.

He also touched on social impact bonds, a financing m-echa-nism that allows local governments to enter into contracts with businesses so that those businesses can take preventive health-care actions in communities. If the communities become healthier, local government can save on future spending.

A number of recent and upcoming healthcare-related innova-tions and events were also on Nishikawa’s mind—especially the first Well-Aging Society Summit, a global event that gathered healthcare innovation professionals in Japan last October.

The summit was a springboard for METI’s open inno-vation center—the Healthcare Innovation Hub, which will be based in Tokyo’s Nihonbashi area. There, medical professionals, Japanese and non-Japanese corporations, as well as startups can find partners with which to create 21st-century healthcare solutions.

The 2nd Well-Aging Society Summit Asia–Japan, a METI-sponsored conference for healthcare professionals and entre-preneurs, will be held in October. Details will be available at www.meti.go.jp/english and Nishikawa welcomes readers of The ACCJ Journal to join.

Photo: The Post-K supercomputer, jointly developed by Fujitsu Limited and RIKEN

RESEARCH AND RESILIENCEDuring the Kansai Resilience Forum, The ACCJ Journal joined a media tour of some of Kobe’s leading research facilities, including the RIKEN Center for Computational Science, and Kobe City Hospital.

Members of the media had an audience with renowned architect Tadao Ando, designer of the Hyogo Prefectural Museum of Art. Ando delivered a keynote address at the forum in which he emphasized the important role the museum has played in Kobe’s economic and cultural revival and resilience.

Indeed, prior to the 1995 Great Hanshin-Awaji Earthquake, Kobe City’s economic backbone was heavy industry; there was no healthcare industry to speak of. But, as IAFOR chairman and CEO Dr. Joseph Haldane explained, a new focus has been placed on life sciences as part of the region’s economic and social revival.

Leading this transformation in healthcare is the KBIC. The core organization supporting the KBIC is the Foundation for Biomedical Research and Innovation at Kobe (FBRI). The goal of the foundation is “to revitalize Kobe’s economy, enhance local residents’ wellbeing, and contribute to the international community.”

Speaking to The ACCJ Journal, an FBRI representative explained the organiza-tion’s founding principles, as well as its current and future goals. They also highlighted the collaborations between the FBRI and US-based entities, and outlined key enga-gements with corporations, small and medium-sized enterprises (SMEs), and startups.

What is the FBRI?Founded in 2000 to support the development of the Kobe Biomedical Innovation Cluster (KBIC), the FBRI is a center of biomedical industry and research in Kobe. It is a core organization to facilitate fundamental and clinical research, serving as a liaison between laboratory scientists, doctors, and companies.

The FBRI is committed to promoting translational research to bring the outcomes of basic research into clinical application and commercialization, with strengths in medical devices, pharmaceuticals, and regenerative medicine.

We aim to create a system of medical innovation by support­ing every step—from the point of scientific discovery to the release of commercial products and services.

For this purpose, the FBRI engages in a variety of activities, including supporting the operation of clinical trials, research and development (R&D) for cell therapy, and commercialization.

Kobe Biomedical Innovation Cluster

What key organizations fall under the FBRI umbrella?The FBRI consists of four centers:

The Institute of Biomedical Research and Innovation

The Translational Research Center for Medical Innovation

The R&D Center for Cell Therapy (RDC)

The Center for Cluster Development and Coordination (CCD)

Not only does the FBRI promote R&D, it also sup­ports industrialization by encouraging trans-sector alliance. At the CCD, for instance, we have specialists who support researchers and businesses, including by facilitating industry-academia colla­boration, business matching, and global network building.

With the support of the FBRI, the KBIC has been conducting R&D focused on pharmaceuticals, medical devices, and regenera­tive medicine.

In particular, Kobe has attracted worldwide attention as a leader in regenerative medicine. This is the result of promoting translational research within the KBIC.

What are the FBRI’s most-impressive achievements?The world’s first clinical experiment using iPS cells is one of our major results. And many other stem cell-based clinical studies aimed at regenerating human tissues have been carried out and are expected to be put into clinical practice in the years ahead.

As for medical devices, the FBRI provides support to large companies and SMEs. A team of experts in the KBIC—familiar with medical-device R&D and regulatory affairs—provides assistance to SMEs that wish to develop and sell devices. As of the end of March, 42 products have entered the market. Medical devices for minimally invasive treatment, such as robots for medical use, are also under development in the KBIC.

What are the FBRI’s upcoming plans?Supporting startups in life-science fields is one of our commit­ments. Since 2018, the FBRI has had an expert in charge of startup support for new businesses. They take the initiative to consider ideas that may be effective.

Last February, Kobe City, the FBRI, and Bayer AG, a multi­national pharmaceutical and life sciences company, entered into an agreement to find venture companies and entrepreneurs, engage in human resource development, and support commer­cialization and global expansion.